Doctor Account of on board medical emergency
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Join Date: Jun 2002
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Why am I not surprised? There are too many cabin crew (fortunately still a minority) who are not able to deal with the unexpected. They are more worried about rules, procedures and protocols than the lives of their passengers. When things go wrong, they should be prepared to listen and think instead of putting up the barricades. It is cases like this that the compo lawyers have a place - make the short sighted idiots pay.
As an aside, how many instances have there been of bogus medics offering their services in an emergency vs genuine ones? Is this a genuine problem? I have a feeling that these passenger endangering rules were dreamed up by real perverts with very active imaginations.
Also, I hear that some medical people belive that it is illegal to stop CPR when they have started and that if they get involved and their "patient" suffers from a poor outcome, they are liable. Is this truly the case? As many believe this, some off duty nurses and paramedics would prefer to see someone die than get involved.
PM
As an aside, how many instances have there been of bogus medics offering their services in an emergency vs genuine ones? Is this a genuine problem? I have a feeling that these passenger endangering rules were dreamed up by real perverts with very active imaginations.
Also, I hear that some medical people belive that it is illegal to stop CPR when they have started and that if they get involved and their "patient" suffers from a poor outcome, they are liable. Is this truly the case? As many believe this, some off duty nurses and paramedics would prefer to see someone die than get involved.
PM
PM:
It's not illegal to stop CPR when you are exhausted or a return of spontaneous circulation does not return. That point is quite apparent.
Being involved is a problem but usually the 'good Samaritan' concept is applicable but any actions taken must be commensurate with the standards that a professional at the same level would deliver. The USA is a problem as they are far more litigatious than the UK. Most airlines will indemnify the medics for their actions subject to the above standards.
It's not illegal to stop CPR when you are exhausted or a return of spontaneous circulation does not return. That point is quite apparent.
Being involved is a problem but usually the 'good Samaritan' concept is applicable but any actions taken must be commensurate with the standards that a professional at the same level would deliver. The USA is a problem as they are far more litigatious than the UK. Most airlines will indemnify the medics for their actions subject to the above standards.
UK ambulance crew SOP is to resuscitate until reviewed by a doctor, unless putrefying, decapitated or charred. Sometimes they don't try very hard, I suspect, but that's probably hard in an aisle with 300 people watching.
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UK ambulance crew SOP is to resuscitate until reviewed by a doctor, unless putrefying, decapitated or charred. Sometimes they don't try very hard, I suspect, but that's probably hard in an aisle with 300 people watching.
Whilst having never responded to an emergency on Delta, I have on BA/VA/Spirit and without fail having been given total support (and appreciation), from the crew. VA have on (all 3!) occasions have shown their gratitude on board and afterwards from 'HQ' very generously; However I answer the PA call because I'd want someone to do the same for a member of my family, not because of what I might get in return.
HTC
HTC
In Australia, a first responder has never been taken to court.
Every month there are cases of 1st responders moving people out of a car wreck due to a unnecessary fear of fire.
It's likely that a very small percentage of victims suffer further injury.
From my experience as a volunteer there is no paperwork or protocols to backtrack to find 1st responders to give them a hard time, quite right!
But doors are opened if victims wish to thank those who were 1st on scene!
Mickjoebill
Every month there are cases of 1st responders moving people out of a car wreck due to a unnecessary fear of fire.
It's likely that a very small percentage of victims suffer further injury.
From my experience as a volunteer there is no paperwork or protocols to backtrack to find 1st responders to give them a hard time, quite right!
But doors are opened if victims wish to thank those who were 1st on scene!
Mickjoebill
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As a medic it is certainly not illegal to stop CPR. In the first instance, if you are physically incapable of going further, (CPR is exhausting) then you may stop if there is no other assistance. I could imagine a scenario on an aircraft where there is no possibility of essential support such as intubation and respiratory support, that the CPR is evidently futile.
I have, as first responder, (not in an aircraft, it was in a pub) refused to get involved due to the threat of violence.
I have, once, responded to a CC call for assistance. Fortunately the person had suffered something like a transient ischeamic attack (mini stroke) but maintained a full pulse and respiratory effort. CC were very good, although asking questions about diversion that I had little answer to. I did not know how to answer "do we need to divert?" All I could do was to describe the condition of the person. Fortunately I did not need to intervene with actions such as CPR but the patient was semi-conscious and clearly unwell. I had little idea of what a diversion would mean in time or effort. (This flight at the time as over Europe from Moscow) This question was asked very soon after I attended to the patient so I could not judge any improvement or deterioration (Improvement was evident a little later) My reply was that I did not know.
I struggled with the issue of diversion. it is far from our minds about where the aircraft should go. Possibly for CC or CRM meetings, it may be useful to have medics attend to describe what questions need to be asked of them. Possibly a direct question - "Do we need to land ASAP? And if so, why?" The second question is not impertinent, it will focus the first responder's mind on urgency. If I had been asked that question directly in this case I would have answered no, and would have said that the patient has a pulse, is breathing and is responding to painful stimulus so is not in extremis, so immediate assistance is not required. Treatment within one to two hours would be optimal. That leaves the professionals on the aircraft to decide what to do.
Maybe for CC it is asking the correct question of the first responder.
I have, as first responder, (not in an aircraft, it was in a pub) refused to get involved due to the threat of violence.
I have, once, responded to a CC call for assistance. Fortunately the person had suffered something like a transient ischeamic attack (mini stroke) but maintained a full pulse and respiratory effort. CC were very good, although asking questions about diversion that I had little answer to. I did not know how to answer "do we need to divert?" All I could do was to describe the condition of the person. Fortunately I did not need to intervene with actions such as CPR but the patient was semi-conscious and clearly unwell. I had little idea of what a diversion would mean in time or effort. (This flight at the time as over Europe from Moscow) This question was asked very soon after I attended to the patient so I could not judge any improvement or deterioration (Improvement was evident a little later) My reply was that I did not know.
I struggled with the issue of diversion. it is far from our minds about where the aircraft should go. Possibly for CC or CRM meetings, it may be useful to have medics attend to describe what questions need to be asked of them. Possibly a direct question - "Do we need to land ASAP? And if so, why?" The second question is not impertinent, it will focus the first responder's mind on urgency. If I had been asked that question directly in this case I would have answered no, and would have said that the patient has a pulse, is breathing and is responding to painful stimulus so is not in extremis, so immediate assistance is not required. Treatment within one to two hours would be optimal. That leaves the professionals on the aircraft to decide what to do.
Maybe for CC it is asking the correct question of the first responder.
At my carrier we don't ask the medic if we should divert. Instead we tell the medic how long we have until we land at our planned destination. We find their assessment of time and need is a better way to determine whether a diversion is required or not.
To answer the opening question. You can generally tell if someone is qualified or not, just on face value. In other words, you can tell the dreamers apart. When dealing with 'medicals' the worst thing is actually those passengers who have taken a first aid course who, not realising crew are first aid trained, can be over enthusiastic.
To answer the opening question. You can generally tell if someone is qualified or not, just on face value. In other words, you can tell the dreamers apart. When dealing with 'medicals' the worst thing is actually those passengers who have taken a first aid course who, not realising crew are first aid trained, can be over enthusiastic.
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Where I work we use a dedicated medical call centre via satphone. They talk with the medical person on scene or crew member if no doctor, paramedic or nurse is on board. They also advise where we should divert to if necessary, depending on problem as they are aware of the cities facilities that we are flying near to at the time.
Our policy is to not release the medical kit until medlink (the company we use) has given the OK after speaking with the attending passenger. There is however a diagnostic kit and AED that is released as soon as anyone says they are qualified and require it.
Our policy is to not release the medical kit until medlink (the company we use) has given the OK after speaking with the attending passenger. There is however a diagnostic kit and AED that is released as soon as anyone says they are qualified and require it.
